People

Traditional birth attendants

Many countries now call on trained physicians and midwives. They often work in hi-tech hospitals, where they are also supervised and monitored, particularly in the West. However, much of the world is still dependent on female traditional birth attendants (TBAs), sometimes referred to as indigenous midwives. These women gain knowledge through practical experience and the oral tradition, rather than formal learning.

TBAs tend to be older women with children of their own. They usually hold status and respect within their community, and often have additional medical knowledge, particularly in herbalism and other traditional healing techniques. TBAs are involved at the birth itself and may assist during pregnancies and in the early post-birth period. They can also help with other health issues and act as a link between a geographically isolated local population and more formal health services.

Recent decades have seen greater regulation and licensing brought to the TBA profession. Major health organisations such as the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) are involved. They instigated programmes to improve the medical skills of TBAs, and closer relationships have been formed with modern health-care providers. They have also introduced formal training and improved provision of medical supplies to communities served by TBAs. However, many TBAs are reluctant to submit to greater regulation, fearing they may lose their traditional roles.